title: Design, manufacture and in-vitro evaluation of a new microvascular anastomotic device.
abstract: BACKGROUND
  Many microvascular anastomoses have been proposed for use with physical assisted methods, such as cuff, ring-pin, stapler, clip to the anastomose blood vessel. The ring-pin type anastomotic device (e.g., 3M Microvascular Anastomotic System) is the most commonly used worldwide because the anastomotic procedure can be conducted more rapidly and with fewer traumas than using sutures. However, problems including vessel leakage, ring slippage, high cost and high surgical skill demand need to be resolved. The aim of this study is to design and manufacture a new anastomotic device for microvascular anastomosis surgery and validate the device functions with in-vitro testing.
  
  
  METHODS
  The new device includes one pair of pinned rings and a set of semi-automatic flap apparatus designed and made using computer-aided design / computer-aided manufacture program. A pair of pinned rings was used to impale vessel walls and establish fluid communication with rings joined. The semi-automatic flap apparatus was used to assist the surgeon to invert the vessel walls and impale onto each ring pin, then turning the apparatus knob to bring the rings together. The device was revised until it became acceptable for clinical requires. An in-vitro test was performed using a custom-made seepage micro-fluid system to detect the leakage of the anastomotic rings. The variation between input and output flow for microvascular anastomoses was evaluated.
  
  
  RESULTS
  The new microvascular anastomotic device was convenient and easy to use. It requires less time than sutures to invert and impale vessel walls onto the pinned rings using the semi-automatic flap apparatus. The in-vitro test data showed that there were no tears from the joined rings seam during the procedures.
  
  
  CONCLUSIONS
  The new anastomotic devices are effective even with some limitations still remaining. This device can be helpful to simplify the anastomosis procedure and reduce the surgery time.
authors.forename: Shao-Fu
authors.initials: SF
authors.lastname: Huang
authors.forename: Tien-Hsiang
authors.initials: TH
authors.lastname: Wang
authors.forename: Hsuan-Wen
authors.initials: HW
authors.lastname: Wang
authors.forename: Shu-Wei
authors.initials: SW
authors.lastname: Huang
authors.forename: Chun-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Hsien-Nan
authors.initials: HN
authors.lastname: Kuo
authors.forename: Tsung-Chih
authors.initials: TC
authors.lastname: Yu
mesh_terms: D000465:Algorithms; D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods; D000818:Animals; D001577:Benzophenones; D001808:Blood Vessels / Q000473:pathology; D017076:Computer-Aided Design; D004867:Equipment Design; D005399:Fishes; D006801:Humans; D007422:Intestines / Q000601:surgery; D007659:Ketones / Q000737:chemistry; D008833:Microcirculation; D008866:Microsurgery / Q000295:instrumentation; D011092:Polyethylene Glycols / Q000737:chemistry; D011108:Polymers; D012815:Signal Processing, Computer-Assisted; D012984:Software; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013524:Surgical Flaps; D013525:Surgical Instruments; D013537:Sutures
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols